Update: AMA Votes Not to Target Ricki Lake

Amie Newman

In response to recent criticism, the American Medical Association removes references to Ricki Lake in its newest resolution but continues its quest to outlaw home birth.

After news coverage spread of the AMA’s recent vote to adopt an anti-home birth resolution and their criticisms of celebrity Ricki Lake and her pro-midwifery/home birth documentary, objections arose from women’s health advocates, reproductive rights organizations, mainstream news outlets, parents and bloggers alike. Even Ricki Lake responded

In response to the criticisms, The Big Push for Midwives Campaign reports that the AMA voted to delete all references to celebrity Ricki Lake in the resolution this week. The AMA cited Lake as a central figure encouraging women to birth at home, apparently against the domineering judgment of the AMA. Even with the deletion of Lake’s name, the organization still voted to proceed with its plans to promote legislation outlawing childbirth at home.

Steff Hedenkamp, Communications Coordinator of The Big Push for Midwives Campaign, says:

"Obviously the AMA was hoping to fly under the radar with its patronizing suggestion that women are choosing to have their babies at home because of something they heard Ricki Lake say on the Today Show. Now that they’ve been called on it, Ricki’s no longer in their sites…If the AMA truly believes that those of us who deliver our babies at home with professional midwives are making such a dangerous choice, then the American public deserves to know exactly how they plan to stop it."

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The British Medical Journal’s recently conducted research, obtained from Citizens for Midwifery, shows that a planned home birth or birth center birth, under the care of a CPM (Certified Professional Midwife) is as safe for the woman and her baby as a planned hospital birth – with much lower rates of intervention as well.

There are many states that now have licensed non-nurse midwives but, says The Big Push Campaign, "…no state has passed a law forcing hospitalization of all laboring women or dictating place of birth."

It’s hard to imagine that legislation such as the American Medical Association is proposing would gain enough support to pass in any state. The thought of creating more barriers to safe health care options for healthy, laboring women seems antithetical to what most Americans seek, especially in this election year where health care reform is a priority topic for candidates and citizens alike. However, the AMA is an extremely well-funded lobbying force which makes these threats easier to imagine.

"At best, we can expect to see them push for window-dressing laws that simply condemn home birth as unsafe but are used to harass families who make this choice, as well as the midwives who work with them," said Susan Jenkins, Legal Counsel for the Big Push for Midwives. "At worst, I fear we could see scenarios very similar to the legislative battle in Missouri over legalizing CPMs, where the medical lobby strong-armed law makers into killing a bill that had broad support from both legislators and the general public."

 

Culture & Conversation Maternity and Birthing

On ‘Commonsense Childbirth’: A Q&A With Midwife Jennie Joseph

Elizabeth Dawes Gay

Joseph founded a nonprofit, Commonsense Childbirth, in 1998 to inspire change in maternity care to better serve people of color. As a licensed midwife, Joseph seeks to transform how care is provided in a clinical setting.

This piece is published in collaboration with Echoing Ida, a Forward Together project.

Jennie Joseph’s philosophy is simple: Treat patients like the people they are. The British native has found this goes a long way when it comes to her midwifery practice and the health of Black mothers and babies.

In the United States, Black women are disproportionately affected by poor maternal and infant health outcomes. Black women are more likely to experience maternal and infant death, pregnancy-related illness, premature birth, low birth weight, and stillbirth. Beyond the data, personal accounts of Black women’s birthing experiences detail discrimination, mistreatment, and violation of basic human rights. Media like the new film, The American Dream, share the maternity experiences of Black women in their own voices.

A new generation of activists, advocates, and concerned medical professionals have mobilized across the country to improve Black maternal and infant health, including through the birth justice and reproductive justice movements.

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Joseph founded a nonprofit, Commonsense Childbirth, in 1998 to inspire change in maternity care to better serve people of color. As a licensed midwife, Joseph seeks to transform how care is provided in a clinical setting.

At her clinics, which are located in central Florida, a welcoming smile and a conversation mark the start of each patient visit. Having a dialogue with patients about their unique needs, desires, and circumstances is a practice Joseph said has contributed to her patients having “chunky,” healthy, full-term babies. Dialogue and care that centers the patient costs nothing, Joseph told Rewire in an interview earlier this summer.

Joseph also offers training to midwives, doulas, community health workers, and other professionals in culturally competent, patient-centered care through her Commonsense Childbirth School of Midwifery, which launched in 2009. And in 2015, Joseph launched the National Perinatal Task Force, a network of perinatal health-care and service providers who are committed to working in underserved communities in order to transform maternal health outcomes in the United States.

Rewire spoke with Joseph about her tireless work to improve maternal and perinatal health in the Black community.

Rewire: What motivates and drives you each day?

Jennie Joseph: I moved to the United States in 1989 [from the United Kingdom], and each year it becomes more and more apparent that to address the issues I care deeply about, I have to put action behind all the talk.

I’m particularly concerned about maternal and infant morbidity and mortality that plague communities of color and specifically African Americans. Most people don’t know that three to four times as many Black women die during pregnancy and childbirth in the United States than their white counterparts.

When I arrived in the United States, I had to start a home birth practice to be able to practice at all, and it was during that time that I realized very few people of color were accessing care that way. I learned about the disparities in maternal health around the same time, and I felt compelled to do something about it.

My motivation is based on the fact that what we do [at my clinic] works so well it’s almost unconscionable not to continue doing it. I feel driven and personally responsible because I’ve figured out that there are some very simple things that anyone can do to make an impact. It’s such a win-win. Everybody wins: patients, staff, communities, health-care agencies.

There are only a few of us attacking this aggressively, with few resources and without support. I’ve experienced so much frustration, anger, and resignation about the situation because I feel like this is not something that people in the field don’t know about. I know there have been some efforts, but with little results. There are simple and cost-effective things that can be done. Even small interventions can make such a tremendous a difference, and I don’t understand why we can’t have more support and more interest in moving the needle in a more effective way.

I give up sometimes. I get so frustrated. Emotions vie for time and energy, but those very same emotions force me to keep going. I feel a constant drive to be in action and to be practical in achieving and getting results.

Rewire: In your opinion, what are some barriers to progress on maternal health and how can they be overcome?

JJ: The solutions that have been generated are the same, year in and year out, but are not really solutions. [Health-care professionals and the industry] keep pushing money into a broken system, without recognizing where there are gaps and barriers, and we keep doing the same thing.

One solution that has not worked is the approach of hiring practitioners without a thought to whether the practitioner is really a match for the community that they are looking to serve. Additionally, there is the fact that the practitioner alone is not going to be able make much difference. There has to be a concerted effort to have the entire health-care team be willing to support the work. If the front desk and access points are not in tune with why we need to address this issue in a specific way, what happens typically is that people do not necessarily feel welcomed or supported or respected.

The world’s best practitioner could be sitting down the hall, but never actually see the patient because the patient leaves before they get assistance or before they even get to make an appointment. People get tired of being looked down upon, shamed, ignored, or perhaps not treated well. And people know which hospitals and practitioners provide competent care and which practices are culturally safe.

I would like to convince people to try something different, for real. One of those things is an open-door triage at all OB-GYN facilities, similar to an emergency room, so that all patients seeking maternity care are seen for a first visit no matter what.

Another thing would be for practitioners to provide patient-centered care for all patients regardless of their ability to pay.  You don’t have to have cultural competency training, you just have to listen and believe what the patients are telling you—period.

Practitioners also have a role in dismantling the institutionalized racism that is causing such harm. You don’t have to speak a specific language to be kind. You just have to think a little bit and put yourself in that person’s shoes. You have to understand she might be in fear for her baby’s health or her own health. You can smile. You can touch respectfully. You can make eye contact. You can find a real translator. You can do things if you choose to. Or you can stay in place in a system you know is broken, doing business as usual, and continue to feel bad doing the work you once loved.

Rewire: You emphasize patient-centered care. Why aren’t other providers doing the same, and how can they be convinced to provide this type of care?

JJ: I think that is the crux of the matter: the convincing part. One, it’s a shame that I have to go around convincing anyone about the benefits of patient-centered care. And two, the typical response from medical staff is “Yeah, but the cost. It’s expensive. The bureaucracy, the system …” There is no disagreement that this should be the gold standard of care but providers say their setup doesn’t allow for it or that it really wouldn’t work. Keep in mind that patient-centered care also means equitable care—the kind of care we all want for ourselves and our families.

One of the things we do at my practice (and that providers have the most resistance to) is that we see everyone for that initial visit. We’ve created a triage entry point to medical care but also to social support, financial triage, actual emotional support, and recognition and understanding for the patient that yes, you have a problem, but we are here to work with you to solve it.

All of those things get to happen because we offer the first visit, regardless of their ability to pay. In the absence of that opportunity, the barrier to quality care itself is so detrimental: It’s literally a matter of life and death.

Rewire: How do you cover the cost of the first visit if someone cannot pay?

JJ: If we have a grant, we use those funds to help us pay our overhead. If we don’t, we wait until we have the women on Medicaid and try to do back-billing on those visits. If the patient doesn’t have Medicaid, we use the funds we earn from delivering babies of mothers who do have insurance and can pay the full price.

Rewire: You’ve talked about ensuring that expecting mothers have accessible, patient-centered maternity care. How exactly are you working to achieve that?

JJ: I want to empower community-based perinatal health workers (such as nurse practitioners) who are interested in providing care to communities in need, and encourage them to become entrepreneurial. As long as people have the credentials or license to provide prenatal, post-partum, and women’s health care and are interested in independent practice, then my vision is that they build a private practice for themselves. Based on the concept that to get real change in maternal health outcomes in the United States, women need access to specific kinds of health care—not just any old health care, but the kind that is humane, patient-centered, woman-centered, family-centered, and culturally-safe, and where providers believe that the patients matter. That kind of care will transform outcomes instantly.

I coined the phrase “Easy Access Clinics” to describe retail women’s health clinics like a CVS MinuteClinic that serve as a first entry point to care in a community, rather than in a big health-care system. At the Orlando Easy Access Clinic, women receive their first appointment regardless of their ability to pay. People find out about us via word of mouth; they know what we do before they get here.

We are at the point where even the local government agencies send patients to us. They know that even while someone’s Medicaid application is in pending status, we will still see them and start their care, as well as help them access their Medicaid benefits as part of our commitment to their overall well-being.

Others are already replicating this model across the country and we are doing research as we go along. We have created a system that becomes sustainable because of the trust and loyalty of the patients and their willingness to support us in supporting them.

Photo Credit: Filmmaker Paolo Patruno

Joseph speaking with a family at her central Florida clinic. (Credit: Filmmaker Paolo Patruno)

RewireWhat are your thoughts on the decision in Florida not to expand Medicaid at this time?

JJ: I consider health care a human right. That’s what I know. That’s how I was trained. That’s what I lived all the years I was in Europe. And to be here and see this wanton disregard for health and humanity breaks my heart.

Not expanding Medicaid has such deep repercussions on patients and providers. We hold on by a very thin thread. We can’t get our claims paid. We have all kinds of hoops and confusion. There is a lack of interest and accountability from insurance payers, and we are struggling so badly. I also have a Change.org petition right now to ask for Medicaid coverage for pregnant women.

Health care is a human right: It can’t be anything else.

Rewire: You launched the National Perinatal Task Force in 2015. What do you hope to accomplish through that effort?

JJ: The main goal of the National Perinatal Task Force is to connect perinatal service providers, lift each other up, and establish community recognition of sites committed to a certain standard of care.

The facilities of task force members are identified as Perinatal Safe Spots. A Perinatal Safe Spot could be an educational or social site, a moms’ group, a breastfeeding circle, a local doula practice, or a community center. It could be anywhere, but it has got to be in a community with what I call a “materno-toxic” area—an area where you know without any doubt that mothers are in jeopardy. It is an area where social determinants of health are affecting mom’s and baby’s chances of being strong and whole and hearty. Therein, we need to put a safe spot right in the heart of that materno-toxic area so she has a better chance for survival.

The task force is a group of maternity service providers and concerned community members willing to be a safe spot for that area. Members also recognize each other across the nation; we support each other and learn from each others’ best practices.

People who are working in their communities to improve maternal and infant health come forward all the time as they are feeling alone, quietly doing the best they can for their community, with little or nothing. Don’t be discouraged. You can get a lot done with pure willpower and determination.

RewireDo you have funding to run the National Perinatal Task Force?

JJ: Not yet. We have got the task force up and running as best we can under my nonprofit Commonsense Childbirth. I have not asked for funding or donations because I wanted to see if I could get the task force off the ground first.

There are 30 Perinatal Safe Spots across the United States that are listed on the website currently. The current goal is to house and support the supporters, recognize those people working on the ground, and share information with the public. The next step will be to strengthen the task force and bring funding for stability and growth.

RewireYou’re featured in the new film The American Dream. How did that happen and what are you planning to do next?

JJ: The Italian filmmaker Paolo Patruno got on a plane on his own dime and brought his cameras to Florida. We were planning to talk about Black midwifery. Once we started filming, women were sharing so authentically that we said this is about women’s voices being heard. I would love to tease that dialogue forward and I am planning to go to four or five cities where I can show the film and host a town hall, gathering to capture what the community has to say about maternal health. I want to hear their voices. So far, the film has been screened publicly in Oakland and Kansas City, and the full documentary is already available on YouTube.

RewireThe Black Mamas Matter Toolkit was published this past June by the Center for Reproductive Rights to support human-rights based policy advocacy on maternal health. What about the toolkit or other resources do you find helpful for thinking about solutions to poor maternal health in the Black community?

JJ: The toolkit is the most succinct and comprehensive thing I’ve seen since I’ve been doing this work. It felt like, “At last!”

One of the most exciting things for me is that the toolkit seems to have covered every angle of this problem. It tells the truth about what’s happening for Black women and actually all women everywhere as far as maternity care is concerned.

There is a need for us to recognize how the system has taken agency and power away from women and placed it in the hands of large health systems where institutionalized racism is causing much harm. The toolkit, for the first time in my opinion, really addresses all of these ills and posits some very clear thoughts and solutions around them. I think it is going to go a long way to begin the change we need to see in maternal and child health in the United States.

RewireWhat do you count as one of your success stories?

JJ: One of my earlier patients was a single mom who had a lot going on and became pregnant by accident. She was very connected to us when she came to clinic. She became so empowered and wanted a home birth. But she was anemic at the end of her pregnancy and we recommended a hospital birth. She was empowered through the birth, breastfed her baby, and started a journey toward nursing. She is now about to get her master’s degree in nursing, and she wants to come back to work with me. She’s determined to come back and serve and give back. She’s not the only one. It happens over and over again.

This interview has been edited for length and clarity.

Roundups Politics

Trump Taps Extremists, Anti-Choice Advocates in Effort to Woo Evangelicals

Ally Boguhn

Representatives from radical anti-abortion group Operation Rescue praised Trump’s commitment to its shared values during the event. “I’m very impressed that Mr. Trump would sit with conservative leaders for multiple questions, and then give direct answers,” said the organization's president, Troy Newman, who was in attendance at a question-and-answer event on Tuesday.

Making a play to win over the evangelical community, presumptive Republican nominee Donald Trump met with more than 1,000 faith and anti-choice leaders on Tuesday for a question-and-answer event in New York City and launched an “evangelical advisory board” to weigh in on how he should approach key issues for the voting bloc.

The meeting was meant to be “a guided discussion between Trump and diverse conservative Christian leaders to better understand him as a person, his position on important issues and his vision for America’s future,” according to a press release from the event’s organizers. As Rewire previously reported, numerous anti-choice and anti-LGBTQ leaders—many of them extremists—were slated to attend.

Though the event was closed to the media, Trump reportedly promised to lift a ban on tax-exempt organizations from politicking and discussed his commitment to defending religious liberties. Trump’s pitch to conservatives also included a resolution that upon his election, “the first thing we will do is support Supreme Court justices who are talented men and women, and pro-life,” according to a press release from United in Purpose, which helped organize the event.

Marjorie Dannenfelser, president of the anti-choice Susan B. Anthony List, told the New York Times that the business mogul also reiterated promises to defund Planned Parenthood and to pass the Pain-Capable Unborn Child Protection Act, a 20-week abortion ban based on the medically unsupported claim that a fetus feels pain at that point in a pregnancy.

In a post to its website, representatives from radical anti-abortion group Operation Rescue praised Trump’s commitment to their shared values during the event. “I’m very impressed that Mr. Trump would sit with conservative leaders for multiple questions, and then give direct answers,” said the group’s president, Troy Newman, who was in attendance. “I don’t believe anything like this has ever happened.” The post went on to note that Trump had also said he would appoint anti-choice justices to federal courts, and repeal and replace the Affordable Care Act (ACA).

Just after the event, Trump’s campaign announced the formation of an evangelical advisory board. The group was “convened to provide advisory support to Mr. Trump on those issues important to Evangelicals and other people of faith in America,” according to a press release from the campaign. Though members of the board, which will lead Trump’s “much larger Faith and Cultural Advisory Committee to be announced later this month,” were not asked to endorse Trump, the campaign went on to note that “the formation of the board represents Donald J. Trump’s endorsement of those diverse issues important to Evangelicals and other Christians, and his desire to have access to the wise counsel of such leaders as needed.”

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Much like the group that met with Trump on Tuesday, the presumptive Republican nominee’s advisory board roster reads like a who’s-who of conservatives with radical opposition to abortion and LGBTQ equality. Here are some of the group’s most notable members:

Michele Bachmann

Though former Minnesota Rep. Michele Bachmann once claimed that “women don’t need anyone to tell them what to do on health care” while arguing against the ACA during a 2012 appearance on NBC’s Meet the Press, her views on the government’s role in restricting reproductive health and rights don’t square away with that position.

During a December 2011 “tele-town hall” event hosted by anti-choice organization Personhood USA, Bachmann reportedly falsely referred to emergency contraception as “abortion pills” and joined other Republican then-presidential candidates to advocate for making abortion illegal, even in cases of rape, incest, or life endangerment. During the event, Bachmann touted her support of the anti-choice group’s “personhood pledge,” which required presidential candidates to agree that:

I stand with President Ronald Reagan in supporting “the unalienable personhood of every American, from the moment of conception until natural death,” and with the Republican Party platform in affirming that I “support a human life amendment to the Constitution, and endorse legislation to make clear that the 14th Amendment protections apply to unborn children.

Such a policy, if enacted by lawmakers, could outlaw abortion and many forms of contraception. A source from Personhood USA told the Huffington Post that Bachmann “signed the pledge and returned it within twenty minutes, which was an extraordinarily short amount of time.”

Bachmann has also claimed that God told her to introduce a measure to block marriage equality in her home state, that being an LGBTQ person is “ part of Satan,” and that same-sex marriage is a “radical experiment that will have “profound consequences.”

Mark Burns

Televangelist Mark Burns has been an ardent supporter of Trump, even appearing on behalf of the presidential candidate at February’s Faith and Family Forum, hosted by the conservative Palmetto Family Council, to deliver an anti-abortion speech.

In March, Burns also claimed that he supported Donald Trump because Democrats like Hillary Clinton supported Black “genocide” (a frequently invoked conservative myth) during an appearance on the fringe-conspiracy program, the Alex Jones show. “That’s really one of my major platforms behind Donald Trump,” said Burns, according to the Daily Beast. “He loves babies. Donald Trump is a pro-baby candidate, and it saddens me how we as African Americans are rallying behind … a party that is okay with the genocide of Black people through abortion.”

Burns’ support of Trump extended to the candidate’s suggestion that if abortion was made illegal, those who have abortions should be punished—an issue on which Trump has repeatedly shifted stances. “If the state made it illegal and said the premature death of an unborn child constituted murder, anyone connected to that crime should be held liable,” Burns told the Wall Street Journal in April. “If you break the law there should be punishment.”

Kenneth and Gloria Copeland

Kenneth and Gloria Copeland founded Kenneth Copeland Ministries (KCM), which, according to its mission statement, exists to “teach Christians worldwide who they are in Christ Jesus and how to live a victorious life in their covenant rights and privileges.” Outlining their opposition to abortion in a post this month on the organization’s website, the couple wrote that abortion is wrong even in cases of rape, incest, or life endangerment. “As the author of life, God considers an unborn child to be an eternal being from the moment of its conception,” explained the post. “To deliberately destroy that life before birth would be as much premeditated murder as taking the life of any other innocent person.”

The article went on to say that though it may “seem more difficult in cases such as those involving rape or incest” not to choose abortion, “God has a plan for the unborn child,” falsely claiming that the threat of life endangerment has “been almost completely alleviated through modern medicine.”

The ministries’ website also features Pregnancy Options Centre, a crisis pregnancy center (CPC) in Vancouver, Canada, that receives “financial and spiritual support” from KCM and “its Partners.” The vast majority of CPCs  regularly lie to women in order to persuade them not to have an abortion.

Kenneth Copeland, in a June 2013 sermon, tied pedophilia to the Supreme Court’s decision in Roe v. Wade, going on to falsely claim that the ruling did not actually legalize abortion and that the decision was “the seed to murder our seed.” Copeland blamed legal abortion for the country’s economic woes, reasoning that there are “several million taxpayers that are not alive.”

Copeland, a televangelist, originally supported former Republican presidential candidate Sen. Ted Cruz (TX) in the 2016 Republican primary, claiming that the candidate had been “called and appointed” by God to be the next president. His ministry has previously faced scrutiny about its tax-exempt status under an investigation led by Sen. Chuck Grassley (R-IA) into six ministries “whose television preaching bankrolled leaders’ lavish lifestyles.” This investigation concluded in 2011, according to the New York Times.

James Dobson

James Dobson, founder and chairman emeritus of Focus on the Family (FoF), previously supported Cruz in the Republican primary, releasing an ad for the campaign in February praising Cruz for defending “the sanctity of human life and traditional marriage.” As Rewire previously reported, both Dobson and his organization hold numerous extreme views:

Dobson’s FoF has spent millions promoting its anti-choice and anti-LGBTQ extremism, even dropping an estimated $2.5 million in 2010 to fund an anti-choice Super Bowl ad featuring conservative football player Tim Tebow. Dobson also founded the … Family Research Council, now headed by Tony Perkins.

Dobson’s own personal rhetoric is just as extreme as the causes his organization pushes. As extensively documented by Right Wing Watch,

Dobson has:

Robert Jeffress

A Fox News contributor and senior pastor of First Baptist Church of Dallas, Jeffress once suggested that the 9/11 attacks took place because of legal abortion. “All you have to do is look in history to see what God does with a nation that sanctions the killing of its own children,” said Jeffress at Liberty University’s March 2015 convocation, according to Right Wing Watch. “God will not allow sin to go unpunished and he certainly won’t allow the sacrifice of children to go unpunished.”

Jeffress spoke about the importance of electing Trump during a campaign rally in February, citing Democrats’ positions on abortion rights and Trump’s belief “in protecting the unborn.” He went on to claim that if Sen. Bernie Sanders (I-VT) or Hillary Clinton were elected, “there is no doubt you’re going to have the most pro-abortion president in history.”

After Trump claimed women who have abortions should be punished should it become illegal, Jeffres rushed to defend the Republican candidate from bipartisan criticism, tweeting: “Conservatives’ outrage over @realDonaldTrump abortion comments hypocritical. Maybe they don’t really believe abortion is murder.”

As documented by Media Matters, Jeffress has frequently spoken out against those of other religions and denominations, claiming that Islam is “evil” and Catholicism is “what Satan does with counterfeit religion.” The pastor has also demonstrated extreme opposition to LGBTQ equality, even claiming that same-sex marriage is a sign of the apocalypse.

Richard Land

Richard Land, now president of the Southern Evangelical Seminary, was named one of Time Magazine‘s “25 Most Influential Evangelicals in America” in 2005 for his close ties with the Republican party. While George W. Bush was president, Land participated in the administration’s “weekly teleconference with other Christian conservatives, to plot strategy on such issues as gay marriage and abortion.” Bush also appointed Land to the U.S. Commission on International Religious Freedom in 2002.

According to a 2002 article from the Associated Press, during his early academic career in Texas, “Land earned a reputation as a leader among abortion opponents and in 1987 became an administrative assistant to then-Texas Gov. Bill Clements, who fought for laws to restrict a woman’s right to an abortion” in the state.

Land had previously expressed “dismay” that some evangelicals were supporting Trump, claiming in October that he “take[s] that [support] as a failure on our part to adequately disciple our people.”

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